Stroke is the leading cause of adult disability and costs U.S. taxpayers >$60 billion annually. Interventions designed to educate patients to seek treatment sooner when a stroke occurs may increase low rates of treatment with thrombolysis (current rates 3% national average). Thrombolysis can increase the odds of minimal to zero disability from stroke if emergency medical system response times and in-hospital response times are optimized (maximum time from symptom onset to intravenous thrombolysis is 4.5 hours). Black and Hispanic Americans have higher stroke incidence compared to Whites and are less likely to receive thrombolysis for acute stroke. The latency to hospital arrival is largely dependent on patients'recognition of stroke symptoms, and immediate presentation to the emergency department. Our group has found very low stroke literacy rates among Blacks and Hispanics compared to Whites, which may, in part, be responsible for disparities in acute stroke treatment. Building on our previous work, in which the investigators have identified barriers to increasing stroke literacy and behavioral intent to call 911, the investigators will develop and evaluate the effectiveness of a novel, culturally tailored intervention using storytelling (narrative persuasion) in the form of two professionally produced 12-min films (in English and Spanish), in minority populations in New York City. The investigators hypothesize that participants in the intervention arm (who view the stroke education film) will demonstrate greater behavioral intent to call 911 for suspected stroke compared to those in the usual care arm, who will receive written stroke education materials. Behavioral intent to call 911 will be assessed immediately after viewing the film, 6 months later, and one year later.

Score on Stroke Action Test [ Time Frame: Within one hour of stroke education intervention. ] [ Designated as safety issue: No ]

The validated Stroke Action Test will be used to measure behavioral intent to call 911 for suspected stroke. This test will be administered at immediate post intervention, 6 months and 1 year following the intervention compared to those in the usual care (UC) arm.

Secondary Outcome Measures:

Score on Stroke Action Test [ Time Frame: Within six months of stroke education intervention. ] [ Designated as safety issue: No ]

The validated Stroke Action Test will be used to measure behavioral intent to call 911 for suspected stroke. This test will be administered at immediate post intervention, 6 months and 1 year following the intervention compared to those in the usual care (UC) arm.

Score on Stroke Action Test [ Time Frame: Within one year of stroke education intervention. ] [ Designated as safety issue: No ]

The validated Stroke Action Test will be used to measure behavioral intent to call 911 for suspected stroke. This test will be administered at immediate post intervention, 6 months and 1 year following the intervention compared to those in the usual care (UC) arm.

Other Outcome Measures:

Time to emergency room after suffering a stroke [ Time Frame: Up to 3.5 years post-intervention ] [ Designated as safety issue: No ]

The investigators hypothesize that subjects assigned to the intervention arm will demonstrate a smaller delay in getting to the emergency room after having suffered a stroke, compared to subjects in the control arm, using (an average of) 3.5 years follow-up.

A novel, culturally tailored intervention using storytelling (narrative persuasion) in the form of two professionally produced 12-min films (in English and Spanish), in minority populations in New York City.

Behavioral: Stroke Education Film Viewing

A novel, culturally tailored intervention using storytelling (narrative persuasion) in the form of two professionally produced 12-min films (in English and Spanish), in minority populations in New York City.

Usual Care Group

"Usual Care": Stroke Education pamphlet and brochure distribution.

Other: Stroke Education Pamphlet Exposure

"Usual Care": Stroke Education pamphlet and brochure distribution.

Eligibility

Ages Eligible for Study:

34 Years and older

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

No prior history of stroke;

High risk (defined as a history of one or more stroke risk factor (HTN, diabetes, tobacco, abdominal obesity, heart disease, high cholesterol);

Over age 34 years at onset of intervention (we have selected this age cut off due to the large increase in stroke incidence among minority groups at age 34 );

Self-identified as Black or Hispanic; and

Member of a church congregation who lives in a household with a telephone.

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01909271